How long is a green card medical exam (Form I-693) valid?
TL;DR: If your Form I-693 was properly completed and signed by a civil surgeon on or after November 1, 2023, USCIS treats it as valid indefinitely for that green card case — no more racing a 2-year clock. If it was signed before November 1, 2023, the older 2-year validity rule still applies. Always check the signature date on your specific form, since USCIS policy changed mid-stream and older guidance still floats around online.
The claim
For years, a Form I-693 medical exam only "counted" for 2 years from the civil surgeon's signature, which forced applicants stuck in long USCIS backlogs to redo (and repay for) the exam. USCIS changed this in an April 2024 policy manual update: exams signed on or after November 1, 2023 no longer expire for evidentiary purposes.
The evidence
USCIS's own policy manual (Volume 8, Part B, Chapter 4) and its official newsroom alert confirm the change directly: "a Form I-693 properly completed and signed by a civil surgeon on or after Nov. 1, 2023, was valid indefinitely" to show the applicant isn't inadmissible on health-related grounds. Forms signed before that date keep the older 2-year validity window. This matters enormously for anyone whose I-485 has been pending a long time — you may not need to pay for and repeat the exam at all if your original form was signed on or after that date.
Old rule vs current rule
| Signature date on I-693 | Validity | Practical effect |
|---|---|---|
| Signed before Nov 1, 2023 | 2 years from the civil surgeon's signature | Must be redone if your green card case runs past that window |
| Signed on or after Nov 1, 2023 | Valid indefinitely for that case | No expiration pressure regardless of how long USCIS takes |
Step-by-step: check whether you need a new medical exam
- Find the signature date on your existing Form I-693 (not the date you filed I-485 — the civil surgeon's signature date is what matters).
- If the signature date is before November 1, 2023, assume the 2-year rule applies and check whether that window has already closed.
- If the signature date is on or after November 1, 2023, you likely don't need a new exam for this same green card case, even if it's been pending for years — confirm current guidance on uscis.gov before assuming, since policy can be updated again.
- If you do need a new exam, schedule with a USCIS-designated civil surgeon — not any doctor — and bring your vaccination records to avoid unnecessary re-testing.
- Submit the completed, sealed I-693 exactly as instructed (unopened envelope, if applicable) with your I-485 or in response to a Request for Evidence.
- Keep your own copy of the results and the envelope until your case is fully decided.
- If your I-485 is transferred between service centers or significantly delayed, recheck this rule — validity policy has changed before and could again.
FAQ
Does the indefinite validity rule apply retroactively to old exams? No — only exams signed on or after November 1, 2023 get indefinite validity. Older exams still follow the 2-year rule from their original policy period.
Do I need a new I-693 if I switch categories (e.g., from employment-based to marriage-based)? Generally the same valid I-693 can be reused for a different green card category as long as it's still valid and covers the same applicant, but confirm with your attorney or USCIS guidance for your specific case.
Who can perform the I-693 exam? Only a USCIS-designated civil surgeon — a regular primary care doctor without that designation cannot complete this form for immigration purposes.
What vaccinations are required for the I-693? Requirements follow current CDC/ACIP recommendations and can include MMR, Tdap, varicella, COVID-19, and others depending on age and existing immunity — your civil surgeon determines what applies to you.
Can I get a religious or medical exemption from vaccination requirements? Yes, waivers exist for religious/moral objections and medical contraindications, but they require a formal waiver application (Form I-601) in most cases — this isn't a simple opt-out.
What if I lose my sealed I-693 envelope? Contact the civil surgeon's office for a reissued copy; USCIS generally requires the exam in the proper sealed format, so don't submit an opened or altered envelope.
By Pinal Dave Last updated: 2026-07-31